ABSTRACT
There is an increasingly recognition of the concept of personal recovery in the treatment of mental illness. Recovery defined as living a fulfilling, rewarding life, even in the ongoing presence of a mental illness. Consequently, a number of different instruments have been designed to assess recovery-oriented outcomes. The objective of the study was to conduct a systematic revision of the domains and the instruments used to assess personal recovery and mental health services orientation to recovery. After the systematic review, it has been carried out a selection process of the most adequate instruments taking into account different criteria of adequacy, psychometric properties and the validation to the Spanish population. In the results have been obtained 35 instruments for measuring personal recovery and 18 for assessing the orientation of recovery in mental health services. However, many of them have been dismissed for not reaching the adequacy criteria. This review makes clear the lack of consensus on the concept of recovery, as a consequence of the high number of instruments that evaluate the same concept through different domains. In addition, few instruments offer data related to the psychometric properties and only one instrument to assess personal recovery is validated to the Spanish population.
Subject(s)
Mental Health Recovery , Humans , Mental Disorders/psychology , Mental Disorders/rehabilitation , Mental Disorders/therapyABSTRACT
En los últimos años se ha producido un incremento en el reconocimiento del concepto de recuperación personal en la atención a las personas que padecen enfermedades mentales: la recuperación personal definida como la búsqueda de una vida satisfactoria y plena a pesar de las limitaciones causadas por la enfermedad. Consecuentemente, se han creado diferentes instrumentos para evaluar los resultados orientados a la recuperación. El principal objetivo de este estudio ha sido llevar a cabo una revisión sistemática de los dominios e instrumentos que evalúan tanto la recuperación a nivel personal como la orientación de los servicios hacia la recuperación. Tras la revisión sistemática se ha realizado un proceso de selección de los instrumentos más apropiados teniendo en cuenta distintos criterios de adecuación, propiedades psicométricas y su validación al castellano. Como resultado se han obtenido 35 instrumentos que evalúan la recuperación personal y 18 la orientación de los servicios de salud mental, aunque muchos de ellos han sido desestimados por no cumplir los criterios de adecuación. Esta revisión deja clara la falta de consenso en el concepto de recuperación, debido al alto número de instrumentos que evalúan el mismo concepto a través de diferentes dominios. Además, solo unos pocos ofrecen datos de evidencia de las propiedades psicométricas y únicamente un instrumento desarrollado para evaluar la recuperación personal está adaptado al español
There is an increasingly recognition of the concept of personal recovery in the treatment of mental illness. Recovery defined as living a fulfilling, rewarding life, even in the ongoing presence of a mental illness. Consequently, a number of different instruments have been designed to assess recovery-oriented outcomes. The objective of the study was to conduct a systematic revision of the domains and the instruments used to assess personal recovery and mental health services orientation to recovery. After the systematic review, it has been carried out a selection process of the most adequate instruments taking into account different criteria of adequacy, psychometric properties and the validation to the Spanish population. In the results have been obtained 35 instruments for measuring personal recovery and 18 for assessing the orientation of recovery in mental health services. However, many of them have been dismissed for not reaching the adequacy criteria. This review makes clear the lack of consensus on the concept of recovery, as a consequence of the high number of instruments that evaluate the same concept through different domains. In addition, few instruments offer data related to the psychometric properties and only one instrument to assess personal recovery is validated to the Spanish population
Subject(s)
Humans , Mental Health Recovery , Mental Disorders/psychology , Mental Disorders/rehabilitation , Mental Disorders/therapyABSTRACT
BACKGROUND: Preventable mortality is a good indicator of possible problems to be investigated in the primary prevention chain, making it also a useful tool with which to evaluate health policies particularly public health policies. This study describes inequalities in preventable avoidable mortality in relation to socioeconomic status in small urban areas of thirty three Spanish cities, and analyses their evolution over the course of the periods 1996-2001 and 2002-2007. METHODS: We analysed census tracts and all deaths occurring in the population residing in these cities from 1996 to 2007 were taken into account. The causes included in the study were lung cancer, cirrhosis, AIDS/HIV, motor vehicle traffic accidents injuries, suicide and homicide. The census tracts were classified into three groups, according their socioeconomic level. To analyse inequalities in mortality risks between the highest and lowest socioeconomic levels and over different periods, for each city and separating by sex, Poisson regression were used. RESULTS: Preventable avoidable mortality made a significant contribution to general mortality (around 7.5%, higher among men), having decreased over time in men (12.7 in 1996-2001 and 10.9 in 2002-2007), though not so clearly among women (3.3% in 1996-2001 and 2.9% in 2002-2007). It has been observed in men that the risks of death are higher in areas of greater deprivation, and that these excesses have not modified over time. The result in women is different and differences in mortality risks by socioeconomic level could not be established in many cities. CONCLUSIONS: Preventable mortality decreased between the 1996-2001 and 2002-2007 periods, more markedly in men than in women. There were socioeconomic inequalities in mortality in most cities analysed, associating a higher risk of death with higher levels of deprivation. Inequalities have remained over the two periods analysed. This study makes it possible to identify those areas where excess preventable mortality was associated with more deprived zones. It is in these deprived zones where actions to reduce and monitor health inequalities should be put into place. Primary healthcare may play an important role in this process.
